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Petition to Convert a Design Application under 35 U.S.C. Chapter 16

IC 265199 under ICR 202411-0651-006 · OMB 0651-0075.

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IC Title:	Petition to Convert a Design Application under 35 U.S.C. Chapter 16	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 1.1052

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title: Patent Application Files	FR Citation: 78 FR 19243

Number of Respondents: 3	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3	0	3
Annual IC Time Burden (Hours)	12	0	12
Annual IC Cost Burden (Dollars)	312	24	288

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.